NPI | 1790213783 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: KS 04-45829) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MO 2022008451) |
Enumeration Date | 2017-06-02 |
Last Update Date | 2023-11-28 |